- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,789.31 / $16,152.20 / $21,089.00
| Facility | | $7,789.31 | $16,152.20 | $21,089.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,750.31 / $39,498.44
| Facility | | $5,840.42 | $14,750.31 | $39,498.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,126.54 / $15,090.96 / $22,802.61
| Facility | | $9,126.54 | $15,090.96 | $22,802.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,430.71 / $21,430.71 / $21,430.71
| Facility | | $21,430.71 | $21,430.71 | $21,430.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,149.58 / $15,202.78 / $23,476.66
| Facility | | $13,149.58 | $15,202.78 | $23,476.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,750.31 / $39,498.44
| Facility | | $5,840.42 | $14,750.31 | $39,498.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,750.31 / $30,868.38
| Facility | | $5,840.42 | $14,750.31 | $30,868.38 |